97 articles - From Friday May 06 2022 to Friday May 13 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Endoscopy |
Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2022. ESGE recommends that, after an endoscopically complete resection, if there is a positive horizontal margin or if resection is piecemeal, but there is no submucosal invasion and no other high risk criteria are met, this should be considered a local-risk resection and endoscopic surveillance or re-treatment is recommended rather than surgery or other additional treatment. ESGE recommends that when there is a diagnosis of lymphovascular invasion, or deeper infiltration than sm1, or positive vertical margins, or undifferentiated tumor, or, for colorectal lesions, budding grade 2 or 3, this should be considered a high risk (noncurative) resection, and complete staging and strong consideration for additional treatments should be considered on an individual basis in a multidisciplinary discussion. ESGE recommends scheduled endoscopic surveillance with high definition white-light and chromoendoscopy (virtual or dye-based) with biopsies of only the suspicious areas after a curative ESD. |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
Fibrosis-stage Specific Incidence of Hepatocellular Cancer after Hepatitis C Cure with Direct-Acting Antivirals: A Systematic Review & Meta-analysis. Pooled HCC incidence after SVR in patients with cirrhosis was very high (2.99/100 person-years), but may be declining as longer time accrues after SVR. In patients without cirrhosis, including F3 fibrosis, HCC incidence was lower than thresholds associated with cost-effective HCC screening. In patients with F3 fibrosis, the lack of between-study heterogeneity provides strong evidence that HCC screening may not be warranted. |
Mortality Outcomes by Fibrosis Stage in Non-alcoholic Fatty Liver Disease. A Systematic Review and Meta-Analysis. Stage 3-4 fibrosis had a higher all-cause (HR 3.32) and liver-related mortality (HR 10.40) compared with stage 0-2 fibrosis, while stage 4 fibrosis had higher all-cause (HR: 2.67, CI:1.47-4.83) and liver-related mortality (HR 2.57, CI:1.22-5.42) versus stage 3 fibrosis. Risk of all-cause and liver-related mortality increases substantially with fibrosis stage. These data have important implications for prognostication and trial design. |
| J Crohns Colitis |
A narrative systematic review and categorisation of outcomes in Inflammatory Bowel Disease to inform a Core Outcome Set for real-world evidence. There is substantial variability in outcomes reporting and OMI types. Categorised outcomes and OMI from this review will inform a Delphi consensus on a COS for future RWE in IBD. Data collection standardisation may enhance the quality of RWE applied to decision-making. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Reaching people receiving opioid agonist therapy at community pharmacies with hepatitis C virus: An international randomised controlled trial. Nurse-led PoC diagnosis in pharmacies made HCV care more accessible for OAT clients relative to conventional care. However, strategies to improve testing uptake are required. |
Response-guided long-term treatment of chronic hepatitis D patients with bulevirtide-Results of A "real world" Study. Long-term BLV monotherapy is safe and effectively decreases HDV-RNA and ALT-even in patients with cirrhosis. The optimal duration of BLV treatment alone or in combination with PEG-IFN remains to be established. An algorithm for a response-guided BLV treatment approach is proposed. |
Stopping nucleot(s)ide analogues in non-cirrhotic HBeAg-negative chronic hepatitis B patients: HBsAg loss at 96 Virological reactivation was very common after stopping NA therapy and occurred earlier after stopping TDF versus ETV. The majority of patients had ALT <2× ULN at week 96, but only one-third achieved disease remission and HBsAg loss was rare. Very low HBsAg levels at baseline were uncommon but predicted for HBsAg loss and disease remission. |
| Am J Gastroenterol |
CANNABIDIOL FOR FUNCTIONAL DYSPEPSIA WITH NORMAL GASTRIC EMPTYING: A RANDOMIZED, CONTROLLED TRIAL. There were borderline CBD treatment-by-genotype interactions: rs806378 CNR1 with LPDS (p=0.06), and GE solids (p=0.12). Approved doses of CBD used off-label do not relieve FD with normal baseline GE solids or alter gastric motor functions and satiation. CBD treatment-by-gene interactions suggest potential benefit for postprandial distress with CNR1 rs806378 T allele. |
Digestive Health in Sexual and Gender Minority Populations. It is expected al these factors would negatively impact digestive health as well. This review summarizes the impact of social determinants of health and discrimination on health care access, highlights important digestive diseases to consider in the SGM population, and offers solutions to improve and prioritize the health of these communities. We aim to draw attention to SGM-specific issues that impact gastrointestinal health and to spur research that is desperately lacking. |
| Clin Gastroenterol Hepatol |
Increasing Incidence of Pouchitis between 1996 and 2018: A Population-Based Danish Cohort Study. This first population-based study demonstrated a 15% absolute and 38% relative increase in the incidence of pouchitis among patients undergoing surgery between 1996 and 2018, with the greatest cumulative incidence of pouchitis demonstrated in the most recent era (2015-2018). The striking increase in the incidence of pouchitis highlights the need for further research into causes and prevention of pouchitis. |
Prospective Multicenter Study of the Primary Obesity Surgery Endoluminal (POSE2.0) Procedure for Treatment of Obesity. POSE2.0 is an effective and durable endoscopic bariatric therapy which may influence physiologic pathways impacting satiety. Larger comparative studies are needed to further elucidate these initial findings. |
The Natural History of Asymptomatic Gallstones: a Longitudinal Study and Prediction Model. The model demonstrated good discrimination (c-statistic = 0.70) and calibration. In general medical patients with AG, symptoms developed at approximately 2% per year. A predictive model with good calibration could be used to inform patients of their risk of SG. |
| Endoscopy |
Efficacy of a Computer Aided Detection (CADe) system in a FIT-based organized colorectal cancer screening program: a randomized controlled trial (AIFIT study). Incorporating CADe significantly increases ADR and APC in the framework of a FIT-based CRC screening program. The impact of CADe appears to be consistent regardless of the endoscopist baseline ADR. |
Persistent contamination of a duodenoscope working channel in a non-clinical simulated ERCP setting. The other two duodenoscopes only showed incidental contamination. Persistent contamination by Pa-type 1 was seen in one out of three duodenoscopes after exposure to supraphysiological levels of gut microorganisms. No clear explanation was found for this persistent contamination as exposure and handling were identical and no abnormalities of this particular duodenoscope were identified by borescope inspection. |
| Gastroenterology |
OPIOID EXPOSURE DIFFERENTIALLY IMPACTS ESOPHAGEAL BODY CONTRACTION OVER THE LOWER ESOPHAGEAL SPHINCTER. Nearly 2 out of 3 patients with opioid exposure undergoing HRM have dysphagia and greater than 25% of them with dysphagia as the primary symptom have a diagnosis of either DES or HE. Opioid users with spastic disorders have higher symptom burden long-term compared to non-opioid users. |
| Gastrointest Endosc |
Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort. Long-term programmatic screening and surveillance was safe, as major events were rare during follow-up. However, serious cardiopulmonary events were the most common major events. These results highlight the need for detailed assessments of comorbid conditions during routine clinical practice, which could help inform individual decisions regarding the utility of ongoing colonoscopy follow-up. |
Protein Biomarkers in Pancreatic Juice and Serum for Identification of Pancreatic Cancer. High levels of serum CA19-9 and PJ-derived proteins are associated with PDAC. Prospective surveillance studies including individuals at risk of developing PDAC are required to validate these findings. |
| Gut |
Faecal occult blood loss accurately predicts future detection of colorectal cancer. A prognostic model. Participants at lower versus higher risk of future AN or CRC can be accurately identified based on their age, sex and particularly, prior F-Hb concentrations. Risk stratification should be considered based on this information. |
Tacrolimus-binding protein FKBP8 directs myosin light chain kinase-dependent barrier regulation and is a potential therapeutic target in Crohn's disease. Binding to FKBP8, which can be blocked by tacrolimus, is required for MLCK1 recruitment to intercellular junctions and downstream events leading to immune-mediated barrier loss. The observed increases in MLCK1 activity, MLCK1 localisation at cell junctions and perijunctional MLCK1-FKBP8 interactions in CD suggest that targeting this process may be therapeutic in human disease. These new insights into mechanisms of disease-associated barrier loss provide a critical foundation for therapeutic exploitation of FKBP8-MLCK1 interactions. |
| Hepatology |
NAFLD improves risk prediction of type 2 diabetes: with effect modification by sex and menopausal status. The risks of T2D increased with NAFLD severity as assessed by serum fibrosis markers, and the highest relative excess risks were observed in premenopausal women. The addition of NAFLD to conventional risk factors improved risk prediction for incident T2D in both sexes, with a greater improvement in women than men. NAFLD, including more severe NAFLD, is a stronger risk factor for incident T2D in premenopausal women than in post-menopausal women or men; protection against T2D is lost in pre-menopausal women with NAFLD. |
| Inflamm Bowel Dis |
Long-Term Outcomes of the Excluded Rectum in Crohn's Disease: A Multicenter International Study. From our entire cohort of 197 cases, 149 (75.6%) either ultimately lost their rectums or remained symptomatic with retained rectums, while only 28 (14.2%) of 197, and only 4 (5.9%) of 66 with initial perianal disease, were able to achieve reanastomosis without further problems. Four patients developed anorectal dysplasia or cancer. In this multicenter cohort of patients with CD who had fecal diversion, fewer than 15%, and only 6% with perianal disease, achieved reanastomosis without experiencing disease persistence. |
| J Crohns Colitis |
Association between inflammatory bowel disease and spondyloarthritis: findings from a nationwide study in Sweden. In subgroup analyses, associations were most pronounced among patients with Crohn's disease [(OR=5.20; 95%CI:4.59-5.89), and (HR=10.55; 95%CI:9.16-12.15)] and paediatric onset IBD [(OR=3.63; 95%CI:2.35-5.59) and (HR=15.03; 95%CI:11.01-20.53)]. IBD patients more frequently experience SpA both before and after the diagnosis of IBD compared to the general population, supporting evidence of a shared pathophysiology. The variation in SpA comorbidity across IBD subtypes and age-groups, calls for targeted approaches to facilitate timely diagnosis and intervention. |
Bridging Fixed Dose to Body Weight-Based Regimen of Adalimumab in Pediatric Ulcerative Colitis Using a Pharmacometric Modeling Approach: Case Study with the Phase 3 ENVISION I Trial. The population pharmacokinetic/pharmacodynamic model supports the appropriateness of the use of fixed dosing regimen in the pediatric ulcerative colitis population. |
Comparative risk of incident cancer in patients with Inflammatory Bowel Disease with prior non-digestive malignancy according to immunomodulator: a multicenter cohort study. Incident-cancer-free survival rates were not different between patients receiving anti-TNF and those receiving vedolizumab (p=0.56). After adjustment, incidence rates were not different between patients receiving no immunomodulator, anti-TNF or vedolizumab. In this large multicenter cohort study, there was no difference of cancer incidence in IBD patients with prior non-digestive malignancy treated with vedolizumab or anti-TNF. |
Real-world endoscopic and histologic outcomes are correlated with ustekinumab exposure in patients with ulcerative colitis. In this real-word cohort of refractory UC patients initiating UST, more than a third of the patients achieved histologic remission. A drug exposure-response relationship was observed for histo-endoscopic outcomes, with no added value of measuring tissue exposure given the strong correlation with serum exposure. |
| J Hepatol |
The recent outbreak of acute severe hepatitis in children of unknown origin - what is known so far. Until now, seventeen children required liver transplantation, one died. Accordingly, the Centers for Disease Control and Prevention and the European Centre for Diseases Prevention and Control have both issued a warning on a hepatitis of unknown origin in children. This review focuses on the available information concerning this recent outbreak and introduces some of the discussed hypotheses for its development. |
| Neurogastroenterol Motil |
Antroduodenal motility recording identifies characteristic patterns in gastroparesis related to underlying etiology. Antroduodenal motility patterns are different among GP etiologies. A dysmotility spectrum was identified with different patterns ranging from post-surgery GP to idiopathic and diabetic GP. |
Children with functional abdominal pain disorders successfully decrease FODMAP food intake on a low FODMAP diet with modest improvements in nutritional intake and diet quality. The majority of children with FAPD on a dietitian-led LFD successfully decreased high FODMAP food intake. Children with FAPD on the LFD (vs. baseline) modestly improved micronutrient intake and diet quality. |
Latent class analysis does not support the existence of Rome IV functional bowel disorders as discrete entities. The functional bowel disorders may be better characterized as a spectrum of IBS rather than separate disorders. Adopting this pragmatic stance may help to simply diagnosis, treatment, and recruitment of patients to research trials. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
| Gastroenterology |
| Gastrointest Endosc |
| Hepatology |
Endoplasmic Reticulum Stress in Liver Diseases. It is well documented that ER stress contributes to the onset and progression of multiple hepatic pathologies including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), viral hepatitis, liver ischemia, drug toxicity, and liver cancers. Here, we review key studies dealing with the emerging role of ER stress and the UPR in the pathophysiology of liver diseases from cellular, murine, and human models. Specifically, we will summarize current available knowledge on pharmacological and non-pharmacological interventions that may be employed to target maladaptive UPR for the treatment of non-malignant liver diseases. |
| J Hepatol |
Normothermic liver machine perfusion as a dynamic platform for regenerative purposes. What does the future have in store for us? With the current progress in experimental liver transplantation research, (long-term) normothermic machine perfusion may be used in the future as a dynamic platform for regenerative medicine approaches, enabling repair and regeneration of injured donor livers. Currently explored therapeutics such as defatting cocktails, ribonucleic acid interference, senolytics, and stem cell therapy may assist in the repair and/or regeneration of injured livers before transplantation. This review will provide a forecast of the future utility of normothermic machine perfusion for repair and regeneration of damaged donor livers to ultimately decrease the imbalance between donor liver demand and supply. |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Hepatology |
| Inflamm Bowel Dis |
| J Hepatol |